What constitutes a quality community aged care service—client perspectives: An international scoping study

Abstract Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who require assistance to remain living at home, the Federal Government provides a wide range of community care services, the provision of which has increased substantially over the last 15 years. The importance of client preferences, prefaced by the introduction of consumer directed care across community aged care services, has gathered momentum in Australia following legislation in 2015. Older peoples' preferences differ in comparison to younger people with disability and those with mental health concerns. Older people focus more on the provision of services rather than the notion of independent living itself. This scoping review aimed to explore what aspects people aged 65 years and older consider to be important qualities of aged care services delivered in the community. A computerised search in MEDLINE, CINAHL, PubMed and PsychINFO and hand searches of the Cochrane database and Google Scholar were completed in May 2022. Sixty‐two articles met the selection criteria and were included in the review. Data were extracted using a fit‐for‐purpose protocol and analysed using the Miles and Huberman Model for thematic analysis. Results identified five themes representing quality domains that describe features that are important to clients: staff knowledge, respect for clients, a person‐centred approach, a collaborative partnership with clients and clear communication. When providers of community aged care services are planning to assess the quality of their services, these findings could be used to guide their evaluation. This will ensure that future services delivered accommodate the needs and preferences of clients who receive them.


| INTRODUC TI ON
Individual experience is considered one of the keys to quality in healthcare, along with safety and clinical outcomes. Providing feedback on the experience of clients and supporting the organisational team to address any identified problems, leading to improved quality, is the best way to support a service to meet its objectives (Santana et al., 2019).
However, despite the legislated collection of client feedback, its use by healthcare leadership is still limited (Santana et al., 2019). According to Donabedian (1988), the definition and scope of the word 'quality' is significant, such that, before we even begin to measure quality, we need to understand what elements constitute quality. These elements are dependent upon the nature and the extent of the responsibilities of the service being evaluated. Furthermore, Donabedian (1988) identifies the importance of the contribution of interpersonal relationships, being the vehicle enhancing the delivery of technical care, upon which successful outcomes ultimately depend. Aged care services provided in the community involve several interpersonal relationships, including those between clients, support workers and service providers, yet technical aspects of care provided are often the focus of quality reporting across the sector, and preference is given to client satisfaction surveys to reflect client views regarding the services provided (Gill et al., 2011).
Consumer directed care has been the focus in both Australia and internationally by way of promoting choice and autonomy in the way older people choose to live their lives in the community, including their choice of the care and services they receive (Commonwealth of Australia, 2009). Furthermore, the National Health and Hospital Reform Commission (NHHRC), 2010, in its report, 'National Health and Hospital reform commission final report, and patient-centred suggestions for reform', explicitly identified the need for future health reform to improve the experiences of the population groups they serve, by including their voices to direct priorities for future reform (Jowsey et al., 2011). There are three main government objectives for Australian aged care services including accessibility, appropriate to the needs of clients and high quality. A framework of performance indicators is based on these three objectives with the intention of providing information about the equity, efficiency and effectiveness to identify the outputs and outcomes of aged care services (Australian Government Productivity Commission, 2021). Current performance indicator measures defined under the quality objective that relates to client feedback include satisfaction (satisfaction with the range and quality of both formal and informal services provided) and complaints (received by the Aged Care Quality and Safety Commission). Compliance with the Aged Care Quality Standards introduced on 1 July 2019 is an additional performance indicator defined under quality. The government objective intended to measure the appropriateness of services addressing a client's need has no data available to date. The intent of this objective is to measure the extent to which the client and/or their representative had input into planning their care, whether the supports identified in the care planning process were provided and to what extent the interests, customs, beliefs and cultural and ethnic backgrounds of clients were valued and respected (Australian Government Productivity Commission, 2021). In Australia, organisations deliver both federally funded and privately funded services to older Australians living in the community and in residential aged care settings. Federally funded services provided to support clients with care needs to remain living in their own homes include low-level services (Commonwealth Home Support Program) and higher-level care services (home care package).
The use of both services (CHSP and HCP) has grown substantially over the past 10 years with a corresponding increase in the number of organisations providing services, while demand for residential aged care has declined (Australian Government Productivity Commission, 2021).
A scoping literature review was undertaken to explore current international research on the elements clients consider to be important for community aged care services. Aged care services delivered in older people's homes and the community are described and delivered in very different ways, depending on the legislation that governs their delivery in each country. These differences include the assessment criteria used to determine a clients' eligibility to access services, the financial contribution required of clients when receiving services, and the regulatory requirements of individual service providers who deliver these services. Including the voices of older clients living in the community who are receiving aged care services is an integral part of service delivery (Zhou et al., 2021). Currently, there is limited published literature on client perspectives regarding aspects of service quality such as eligibility, financial contributions and the quality of services.
This includes information regarding the quality of the gatekeeper service-in Australia, it is the Aged Care Assessment Program that assesses eligibility for services. The aim of this review was to identify client-derived quality measures relevant to government-funded health policy initiatives (dated no later than 2000) to operate community aged care services. While it is recognised that there are country-specific

What is known about this topic
• Quality measures are a pre-requisite to improving the quality of care by enabling ongoing monitoring and comparing performance against a set of standards and/or measures.
• Many aged care service providers use satisfaction surveys to measure their clients' satisfaction.
• Very few aged care service providers develop satisfaction surveys in partnership with their clients, to ensure the views and opinions of features important to clients are included.

What this paper adds
• The views and preferences of older community aged care service users regarding the provision of a quality service were identified through an international scoping literature review.
• A suite of quality domains that could be used by aged care providers to measure quality from the client's perspective when delivering services in the community. differences, this scoping review focussed on the views and preferences of clients in relation to the qualities they consider to be important in an aged care service, that was delivered in a community setting. Full-text articles were included if there was a reference to (a) either a client, patient or lived experience expert; (b) community aged care services or home care services and (c) quality measure or satisfaction or preference or participation ( Table 1). Data analysis using the 4-step Miles and Huberman's model (1994) for thematic analysis was carried out on the included final articles. Thematic analysis was chosen as the method for interpreting the data due to its flexibility including, the research question of the study, the constitution and size of the sample and the data collection method used (Clarke & Braun, 2017).

| Step 1-Data reduction
The first stage of data reduction was conducted according to step 1 of Miles and Huberman's model (1994) for thematic analysis (Ibrahim-Alhojailan, 2012). Data were extracted from the final articles using a protocol designed by the first author specifically for this purpose. Data elements included: publication date, authors, country, sample/population group, study design, methods used, aims, outcomes, service type and key measures informing results. In line with the aim of the review, detailed extraction occurred, where there was information regarding client (patient) involvement in the planning and development of study protocols and/or development of the study, including pre-and post-data collection. Some studies were inclusive of clients in age groups that were outside of the exclusion criteria of this scoping review and included quantitative data in their results. For the purposes of this study, qualitative data of client's responses in the age groups nominated for inclusion in this scoping review were extracted only. All analyses were performed by the first author (SS) and reviewed by the other authors (CT and MMK), and any disagreements were resolved by discussion.

| Step 2: Identifying themes (validating and establishing reliability)
Data were initially categorised into three broad groups: the aim(s) of the study, methods adopted and key measures used to obtain study outcomes (Ibrahim-Alhojailan, 2012). Data were further simplified to enable conclusions to be drawn. Themes were developed following the identification of recurring patterns in the data. This process involved the reduction of the aims (perceived impact on clients, perception and experiences of clients and client satisfaction), methods adopted (questions asked of clients) and outcomes (frequency of client quotes relating to impact, experience and satisfaction).

| Step 3: Data display
Utilising the data extracted from each article in step 1 and summarised as 'key measures used to obtain study outcomes' (Ibrahim-Alhojailan, 2012) ( Tables 3-7); a third step was undertaken in which similar themes were grouped with a focus on topic rather than

| Step 4: Drawing conclusions from the data
Conclusions were drawn by taking the key attributes of the client's perspectives that informed the definitions for each key quality measure in Step 3 ( Table 2) and grouping these key attributes together by their likeness in meaning (Ibrahim-Alhojailan, 2012).

| Selection and extraction of data
The search initially identified 2288 articles which decreased to 125 at abstract levels, including five literature reviews. The five literature reviews were excluded although their reference lists were scanned for relevant articles. Relevant full texts were reviewed and if they met the inclusion criteria were added to the full-text articles for inclusion. The final 62 articles included seven additional articles that were identified following scanning of the reference list ( Figure 1).

| General paper details
The largest number of publications were from Australia (n = 22), followed by the United Kingdom (n = 8), United States (n = 7), Sweden (n = 6) and Canada (n = 5). The remaining articles were published in the Netherlands (n = 3), Finland (n = 3) and Greece (n = 2) and one was from each Korea, Switzerland, Israel, Norway, Hong Kong and Scotland.
All articles discussed the delivery of a broad range of services such as personal care, domestic assistance, transport and community access, social support, day-to-day assistance with shopping and meal preparation, nursing, allied health and specific community programs such as fall prevention and palliative care.
The study population for most articles was similar, most often being older people living in the community, however, three TA B L E 2 Definitions of key measure of quality and links to relevant included studies from scoping literature review search     Service quality Suitable times for the delivery of services, services delivered by professional staff who treat them with dignity and respect, being treated as an equal partner in the care relationship and being involved in the decision-making process, highly trained staff, care that meets client's needs and is provided by staff who see them as a person beyond their care needs, care that is reliable and consistent articles focussed on support services for people living with dementia (Chester et al., 2018;Faeø et al., 2020;Low et al., 2013), five on Aboriginal and Torres Strait Islander cohorts (Angell et al., 2018;Askew et al., 2016;Holloway et al., 2015;Lukaszyk et al., 2017& Swain & Barclay, 2015, one on older people with mental illness (Mason et al., 2004), one on older people living in low-income areas (Kwak et al., 2017) and two on services for the Veteran community (Jones et al., 2007;Mahoney et al., 2019). The inclusion criteria did not specify whether studies were to be qualitative for inclusion, however, 81% (n = 50) of the included studies were qualitative. The remaining studies were mixed methods (qualitative and quantitative) (n = 3), Discrete Choice Experiment and cross-sectional (n = 1), randomised control trial (n = 1), non-randomised control trial (n = 1) and discrete choice experiment (n = 3).

| Client involvement in the design of methodology
Six of the 62 articles included in this scoping review engaged clients in certain phases of the study, including involving clients in the design of focus group questions, inviting clients to be members of a reference group, involving clients in consultations that were led by clients, involving clients in the development of questionnaires, patient-reported experience measures and a Discrete Choice Experiment survey (Aletras et al., 2010;Angell et al., 2018;Chester et al., 2018;Groenewoud et al., 2008;Mason et al., 2004;Teale & Young, 2015). Qualitative data collected from clients were described in the articles as occurring primarily by focus groups, interviews or surveys (Tables 3-7). One study used a yarning circle which is a process used in Aboriginal and Torres Strait Islander culture (Lukaszyk et al., 2017).

| Identifying themes
The literature revealed recurring patterns of client responses, in each of the key outcome measure categories adopted by each study.  (Harrison et al., 2014), the enactment of empowerment in the care relationship experienced by the older person (McWilliam et al., 2001) and the impact and outcomes of older people in light of financial system changes in England (Moran et al., 2012). One article investigated clients' perspectives on the impact of the care and services they received (Doyle, 2012), and one examined consumer satisfaction in relation to workforce issues (Anderson et al., 2006). One article explored client's satisfaction against the process and structure-related factors (Kajonius & Kazemi, 2016).
Four articles focused on clients from culturally and linguistically diverse backgrounds and explored their experiences and satisfaction with aged care services (Aletras et al., 2010;Kwak et al., 2017;Skaperdas et al., 2010;Suurmond et al., 2016). Five articles specifically included Aboriginal and Torres Strait Islander clients and explored their experiences of chronic disease management using a case management approach (Askew et al., 2016), their perceptions of palliative care (Holloway et al., 2015), their perspectives of the Home Medicine Review Program (Swain & Barclay, 2015) and their preferences of participation in a fall prevention program (Angell et al., 2018) and desired elements of a fall prevention program (Lukaszyk et al., 2017).

| Drawing conclusions from the data
Results of step 4 of the analysis identified five quality domains, within the five key measures of quality that were used to obtain the results of the included articles. A summary of the key attributes of each quality domain, as viewed by clients, is presented in  (Aletras et al., 2010;Mason et al., 2004;Teale & Young, 2015). Knowledge was also viewed as important when providing information to clients about the services and care they were receiving. This included practical aspects such as the cost, extent and duration of the service, quality rating and the qualifications of the staff providing the care (Sefcik et al., 2016). It was important to clients that staff use their knowledge to inform them of their responsibilities in the care relationship, including how the service related to the client and their identified needs, what the service expected of them and what benefits they would receive from the service (Sefcik et al., 2016). The skills and competence of staff consistently affected a clients' satisfaction rating. Anderson et al. (2006) reported clients valued having well-trained, highly knowledgeable and competent staff just as highly as they rated having sufficient staff to provide the services. Clients valued a highly skilled workforce who received adequate training to meet their individual needs (Anderson et al., 2006;Royal Commission, 2020;Spoorenberg et al., 2015). The relationship between a highly skilled workforce and client satisfaction was also evident with clients valuing the use of skilled social work professionals to act as care managers coordinating a clients' care needs (Chesterman et al., 2001;Wang et al., 2022).
Having consistent staff who were well trained was a strong theme throughout the literature that resulted in improved client satisfaction (Byrne et al., 2011;Groenewoud et al., 2008;McCaffrey et al., 2015;Royal Commission, 2020;Samuelsson & Wister, 2000). Lack of professional support provided to clients was identified as another contributing factor in the knowledge of staff quality domain. For instance, Norell Pejner and Brobeck (2018) found clients reported a lack of professional support when seeking out services, which, from the clients' perspective was viewed as professionals lacking knowledge about their individual care needs and situation, and thus withholding care. One particular study explored the differences between staff and clients' perceptions of clients' psychological well-being and found clients rated staff knowledge and their ability to motivate them to engage in activities outside the home, engage with community groups within their age group and engage in hobbies of their interests, as very low (Eloranta et al., 2010). This study reflects the emphasis placed by clients on the importance of community services focussing on the overall psychological well-being of clients.

| Quality domain 2: Respect for client
Treating a client with dignity and respect was an underlying theme that featured strongly in most studies. Two studies focussed on clients' culture and religious preferences, identifying the high-value clients placed on the cultural and religious competence of the provider, enabling staff to treat them with dignity and respect (COTA, 2018; Mason et al., 2004). One study identified specific cultural considerations for Aboriginal and Torres Strait Islander people and the importance of providing community services that are organised by their local health centre in preference to an aged care provider, promoting a trusting and respectful relationship (Swain & Barclay, 2015). Being treated with dignity and respect was rated by clients as a significant indicator contributing to their quality of life, and in home care, quality of life was viewed as more important to clients compared with the quality of care (COTA, 2018). Clients described wanting their privacy respected and being treated with dignity as an important service experience that would increase their likelihood of choosing a provider (Bikker & Thompson, 2006). Clients described common failures of a home care service relating to process or structural aspects, including professional boundaries, describing poor professional attitudes resulting in inappropriate communication between staff (Firbank, 2012). Kajonius and Kazemi (2016) also found process structures were highly important to clients when receiving home care and included being treated with respect, having influence over decisions and receiving appropriate information. A strong and consistent indicator of client dissatisfaction in the study by Anderson et al. (2006), included the mistreatment of clients by staff, with clients insisting staff treat them with dignity and respect. The Australian Royal Commission on aged care quality and safety (2021) explored the quality of care, quality of life and concerns and complaints of aged care clients. Concerns identified by clients as being of high importance included clients being treated like a child, staff body language and staff attitude or conduct which was perceived as staff being rude, unkind and unsupportive. Clients also reported reasons for their unwillingness to share their concerns with others, including not knowing to whom to report their concerns, not knowing how to report their concerns, not having the capacity to report or fearing repercussions if they reported a concern. Samuelsson and Wister (2000)  • clients were less satisfied with psychological and social care (e.g., staff not recognising loneliness and isolation) and • clients were dissatisfied with the support of professionals concerning depression/loneliness.

| DISCUSS ION
This scoping review focused on clients as users of community aged care services, with the aim of gathering information on service quality attributes that clients viewed as important. A second aim was to further explore these quality attributes to identify quality domains that could potentially inform the development of quality indicators to measure the quality of a community aged care service, that truly reflects a client-centred model. To the author's knowledge, this is the first scoping review that focuses on what clients report as important qualities of aged care services delivered in the community.
In this scoping review, it was considered an essential criterion for the inclusion of a study to have an outcome measure reported that reflected the clients' perspective (i.e., satisfaction or participation or viewpoint or preference).
Thus, a unique aspect of this study was specifying evidence of the involvement of a client in a study as essential inclusion crite- • a necessary evil (balancing feelings and resources against having no choice but to accept), • resources make a difference for exerting influence (having knowledge about the availability of home help and previous experience with the assessment process), • feeling exposed or secure in relation to having a guardian family member present (being present but not there, 'they were mainly talking to my wife'; • family participation compensated for the power imbalance between assessors and clients. • not understanding Consumer Directed Care (too much information-overwhelming and confusing), • level of autonomy (between consumers and case managers) and • number of allocated visits for case managers Consumers satisfied: • introduction of the monthly budget statement, however, found them difficult to interpret and understand and • flexibility and control-spending funds in line with their health and well-being goals Client perception of services on quality of life Access to and use of social services: • bouncing around from service to service without getting help, • professionals seen as gatekeepers or 'brakes' inside the system, • clients felt that their concerns often ignored, • deciding at what point to ask for help, • Worried about others with 'poorer health' than themselves who did not have resources either (prioritising others first) and • clients with no children found access to services more difficult.
1. Recognition inside the services: • dissatisfaction with the amount and type of home care-(limited staff time, high staff turnover) and • mistreated by professional staff and being seen as a burden ( and services delivered at suitable times were two performance indicators that reflected quality. In addition, this study showed the underlying constructs of home care quality were satisfaction and suitable times. This study also looked at the variance within the satisfaction ratings of dimensions of home care quality and suggested overall service quality had four aspects including service quality, positive carer quality, negative carer quality and outcome (Jones et al., 2007). The scoping review conducted to inform the results of this paper has explored this topic further, such that, the results have identified five specific domains of quality that truly represent the clients' perspectives of quality community aged care services.  (Table 8). Furthermore, the five quality domains identified in the literature are reflected in all stages of a clients' service experience, thus, confirming the validity of the quality domains identified in this study (Table 8).
Person-centred care was identified as a single-quality domain, but it is also a dominant theme in quality healthcare. Person centredness is a well-recognised term that is used globally in health and social care services with a focus on placing the person at the centre of the delivery of care.
Internationally, England and the United States have led the way in adopting person-centred care, following significant policy reform.
Both countries have mandated requirements for service providers to collect and publish data on patient experiences, which is attached to financial incentives for providers who achieve high measures (Australian Commission on Safety and Quality in Health Care, 2011).
It is not only recognised as important by organisations who deliver care but also by clients who receive care services. It is acknowledged that person-centred care has a significant impact on a persons' experience and has been linked to improved outcomes (Miller & Peck, 2019).  outcomes. Those results clearly identified that satisfaction was not merely related to the prescription of the antibiotic itself, but more so to effective communication displaying compassionate care provided by the treating physician, and the shared decision-making approach taken. Person-centred care adopted in primary healthcare has also demonstrated significant benefits including, a persons' ability to better manage their health (when they are informed and supported to do so), a reduced need to access speciality care, reduced hospitalisation rates and an increase in a persons' self-perception and empowerment (Delaney, 2018). Given the dearth of papers from specific countries internationally (except Australia, n = 22), it is difficult to say more about specific countries and their aged care systems (All countries have eight or less papers).
In Australia, consumer directed care is a legislated requirement in the delivery of government-funded community aged care services. It was introduced as an approach that enabled the consumer (client), to feel empowered and have influence over the care and services they receive (Mc Callum & Rees, 2017). A systematic review of consumer directed care for older people was undertaken by Ottmann et al. (2013), which aimed to identify user preferences for, and satisfaction with, community aged care services, to inform policymakers regarding future directions of consumer directed care models.
Their results showed older people wanted greater involvement in care-related decision-making as well as greater choice and flexibility over how their care was delivered. The study also identified the differences between the preferences of older people in comparison to younger people with disabilities and those with mental health issues, highlighting the importance of future research to focus on what matters most to older people. Involving older people more directly in research is one way this might be achieved. Receiving care and support from competent and knowledgeable staff a , consistent and appropriate care that meets client's individual needs b , support and information to understand how care relates to individual clients c , being informed of the different types of care available c , having staff who are well trained and knowledgeable d , professional staff who treat clients with dignity and respect e , highly trained staff e Respect for clients Client satisfaction a , client experience b , access and choice c , preference and expectation of care d and service quality e Being treated with dignity and respect a , being treated as an equal person in the care relationship a , equality in the care relationship b , consistent and appropriate care that meets their individual needs b , being empowered to contribute to their own care b , being treated with dignity and respect c , having choice and control over daily life (including the ability to maintain social connections with their community, spirituality, cultural, sexual and religious identity) c , services delivered by professional staff who treat them with dignity and respect e.

Person centred approach
Client satisfaction a , client experience b , access and choice c , preference and expectation of care d and service quality e .
Valuing the importance of being able to make decisions about the care they received a , being provided with the opportunity to maintain their personal autonomy b , having choice over the care provided b , having the opportunity to participate in their own care (inclusive of those with language and communication difficulties) c , having flexibility to change care plans in accordance with individual preferences d , having opportunities for connectedness and engage in social and recreational activities d , having the choice of support workers who provide care 4 , choice over what care types are delivered with funds allocated d , having suitable times for the delivery of services e , having care that meets their needs and is provided by staff who see them as a person beyond their care needs e and care that is personalised and adapted to their individual preferences and needs d

Collaborative partnership with a client
Client satisfaction a , client experience b , access and choice c , preference and expectation of care d and service quality e Having positive interpersonal relationships with staff a , being provided with sufficient time to talk to staff a , being treated as an equal partner in the care relationship and being involved in the decision-making process e Clear communication Client satisfaction a , client experience b , access and choice c , preference and expectation of care d and service quality e Being provided with information that is easily understood to enable informed decisions about care b , receiving appropriate information to inform choice (including consumer experience measures) c , being supported and having information to understand how care related to them c , wanting to be informed of the different types of care available c *see Table 2.
It is recognised that older Australians prefer to remain living in their homes rather than moving into residential aged care (Australian Government Productivity Commission, 2021). Measuring the quality of community aged care services is even more important now, not only from the end user's perspective but to also inform stakeholders (including organisations and governments) about the affordability, sustainability and efficacy of such services. In Australia, there is a gap in client-driven quality measures that measure the appropriateness of services in addressing a client's need. Given this is one of the three main objectives set out by the Australian Government to measure aged care services (Australian Government Productivity Commission, 2021), it is now even more important that the opinions and preferences of clients about the aged care services they receive, be included when developing such a measure. The quality domains identified in this scoping review provide valuable information that could be used to inform future quality measures to meet government objectives.

| S TRENG TH S AND LIMITATI ON S
One possible limitation of this review was the exclusion of articles published in languages other than English, which may have resulted in some important evidence being missed and which may have potentially influenced our conclusions. Nevertheless, this review was completed using a systematic approach including the clear identification of all relevant search terms and a thorough and comprehensive search of key databases to ensure all relevant articles were identified and included. In addition, the abstracts of relevant articles were reviewed by one reviewer and the full text was reviewed by two reviewers independently to confirm agreement regarding inclusion/exclusion. Although the data analysis was undertaken by one author only and is another potential limitation, its impact was mitigated by the other authors checking the results.
Overall, we are confident that the review provides a comprehensive summary of the opinions and views of older people regarding quality community service, and that the identified quality domains are based on sound evidence.
Finally, a small number of articles (n = 3) that reported the preferences and experiences of older people living with cognitive impairment were identified and included in the review. Underrepresentation of this client group makes it difficult to draw conclusions from the results that accurately reflect their perceptions regarding a quality aged care service. If their views are to be included in the development of these quality measures, further research to better understand their views is required. In addition, the number of articles that focussed on the perspectives and experiences of Aboriginal and Torres Strait Islander people when receiving community aged care services was limited (n = 5). Similarly, the number of articles that involved clients in the development of questionnaires and surveys used to understand a client's experience, satisfaction and preference were also limited. Thus, their opinions may not have been completely captured, resulting in a narrow representation of experiences and preferences that clients view as quality attributes of community aged care services. This shortcoming is currently being addressed through an increasing emphasis on the importance of including consumers in research activity that impacts them.

| CON CLUS ION
The five quality domains identified in this review that reflect clients' views of important attributes of a quality community aged care service provide an opportunity for community aged care organisations to explore how these could be incorporated to provide clients with a high-quality service. These quality domains could be used to inform the development of quality indicators to measure the quality of aged care services from a clients' perspective.

AUTH O R S CO NTR I B UTI O N
Sandra Smith was responsible for undertaking the literature searching and preparing the initial draft of the manuscript. All authors assessed the articles against inclusion and exclusion criteria, proofread and revised the manuscript.

ACK N OWLED G EM ENT
The authors conducted this research independently and therefore, there are no acknowledgements. Open access publishing facilitated by The University of Queensland, as part of the Wiley -The University of Queensland agreement via the Council of Australian University Librarians.

CO N FLI C T O F I NTE R E S T S
None.

DATA AVA I L A B I L I T Y S TAT E M E N T
The authors will make the data available upon reasonable request.